Child Care in Scandinavia: An Informal Report
by Grace Hechinger & Fred M. Hechinger - 1990
Reports on a study of the way children are provided for in Scandinavia and explores those aspects of the child-care system which are potentially adaptable to American needs. Topics include prenatal and health care, parental leave, home child care, and the cost of education. (Source: ERIC)
Four weeks of intensive study of the way children are provided for in Scandinavia persuaded us that, despite substantial social differences between our country and theirs, much can be learned from their experience of more than a half century at the very time the United States is groping for new ways of caring for its children. We visited numerous child-care institutions in Denmark, Norway, and Sweden and talked with a variety of experts. The most important overall conclusion we reached is that Scandinavia has developed a child policy that has the support of all political parties, from left to right. Part of the reason for such a broad consensus is that the entire population participates in and reaps the benefits of that policy. Affluent as well as poor families, including even royalty, send their children to the child-care institutions and kindergartens.
While Americans tend to raise the objection that Scandinavia is too homogeneous to be viewed as a model for the United States, this is less true today than in the past: There has been a considerable influx of immigrants and political refugees, many of them nonwhite (such as Pakistanis and Africans). Sweden had added more than one million immigrants to its population of 8 million. American policymakers have, in recent years, looked to Japan for an educational model, even though Japan is truly homogeneous, extremely inward-looking, and xenophobic.
Thus, while we agree that the Scandinavian model cannot be imported to the United States in toto, there are vital aspects that should be studied for adaptation to American needs.
PRENATAL AND HEALTH CARE
Scandinavian medical and pediatric experts say that current policies had their beginning in 1935 when it was decided that infant mortality rates were too high. A first step was the introduction of virtually universal prenatal care (expecting families may opt out, but fewer than 1 percent do). Approximately two months before the expected delivery date, health nurses (home visitors) call on the expecting parents to prepare them for the arrival of the child. They check the woman’s health, discuss nutrition, train both expecting mother and father in positive attitudes, and so forth. These visits continue until confinement, when midwives take over. Obstetricians enter the picture only if there is indication of difficulties. Otherwise the physician appears only at the delivery itself.
Home visits continue after birth for as long as they are deemed necessary or useful. Once the home visits cease, mothers are urged to bring their babies to health centers for regular visits. In Norway, we learned that health centers exist even in the smallest hamlets, if necessary in somebody’s living room. Today, infant mortality in Scandinavia is less than half that of the United States. (For African-Americans, the rate is more than three times that of Scandinavia.)
In Stockholm, we visited a center in the middle of the city, above a commercial bank. The young and extremely competent head nurse, who is totally in charge of the operation, received us in the reception area and asked us to take our shoes off. “The babies like to crawl around the floor, and we must make sure that it is clean,” she said. Inside the spotless facility, a number of mothers were waiting to have their babies looked after- weighed and otherwise examined. Well babies come in the morning; sick ones in the afternoon, in order to prevent transmission of diseases. If a condition is serious enough to call for professional medical attention, the nurse calls for a doctor. (“We use antibiotics less than the rest of the world,” the nurse said. “If it is not necessary, you should not give them.”)
Parents pay approximately $10 for each of the first fifteen visits; after that, visits are free-a means of encouraging continued preventive health care. Visits are continued, on a voluntary basis, from birth to age seven. “In the beginning, we go to their homes,” said Inger Tiainen, the nurse in charge. “Then they come once a week to let us see if they are growing and if the breast feeding is OK.” After six weeks, a doctor visits for the first time. Nurse Tiainen has about five hundred children to take care of.
When a child reaches the age of seven, the health files are transferred to the school. It is important to note that these are the only records the schools receive about the preschool activities of the children; no academic or behavioral records are kept in day care and kindergarten.
Even though child care is available at an early agein Denmark at two months and in Sweden at eight months-parents are encouraged to take care of their babies at home. In Denmark, cash benefits (90 percent of normal income up to a maximum of about $400 a week; students and housewives get the same benefits) are offered for four weeks before and for twenty-four weeks after birth. At least ten weeks of leave are offered for either the mother or the father. Women with premature or sick babies get nine months leave. In Sweden, parental leave is given for nine months, and it can be extended to almost twice that time if the parents work half time. A 1989 proposal, approved by all parties, would double leaves to eighteen months. Leaves are paid for out of an insurance fund to which both employees and employers contribute. They are most generous in the public sector and in large corporations. Problems tend to arise in small businesses where specific contracts may provide less generous coverage.
Parents also may take up to sixty days a year with pay to stay home with sick children. As an alternative, home visitors make it possible for parents to go to work knowing that children are given expert care.
THE CHILD-CARE CENTERS
Child-care centers in Denmark accept infants from two months, in Sweden from eight months, and they cover the first three years of life. From age four to the school-starting age of seven, kindergarten takes over. Both are in the same location. The mixing of ages is part of the principle of preschool institutions. The older children are encouraged to take care of the younger ones. For example, we watched two little girls, perhaps four years old, carefully lifting two “babies” into a wheelbarrow and then driving them around the outdoor grounds amid squeals of laughter. A staff member watched from a distance, ready to intervene if safety required it.
All the centers we visited had outdoor facilities, with sandboxes, little plastic channels to create tiny waterways, and bushes to hide behind. Weather permitting, the infants are wheeled outdoors after lunch in baby-carriage-like wooden boxes on wheels for their naps. Older children retire to indoor “sleeping holes” for naps or quiet time.
The centers are not elaborate. Most look like one-story prefabs, with the kindergartens adjoining the child-care units. Though they are simple in outward appearance, the interiors sparkle with natural light and bright color. Over and over, teachers and directors stressed the importance of colored, blue, yellow-in the environment. Every meal- breakfast, lunch, and an afternoon snack are available for all who want it -looked like a party. Tables were set (by the children) with gaily colored plates and cups. The afternoon sandwiches were often decorated with little flags. In the bathrooms, plastic cups and toothbrushes are neatly arranged in a row, each with a child’s photo and the name printed out. “We don’t want children to think of themselves as bananas or elephants,” a director said, in reference to the American practice.
Common to all centers, and key to the children’s and parents’ needs, is the fact that they are open from early morning (between 7:00 and 8:00 A.M.) until early evening to permit mothers or fathers to drop the children off on the way to work and pick them up after work. In Copenhagen, we even visited a center attached to a hospital that was open seven days a week to accommodate the children of hospital staffs. In Sweden, a few “nighties” have begun to show up-centers that take care of children of blue-collar workers on night shifts.
The centers are well staffed. Groups of ten to twelve children are supervised by two to three adults. Older children in kindergarten may be in groups of twenty to thirty, with the same number of adults. Professionals have three years of college training with special emphasis on dealing with children. As in the United States, they experience some problems of pay and status in comparison with elementary school teachers.
Under present rules (actually by law in Denmark), children in these preschool programs are not allowed to be formally taught. The old-fashioned idea of letting children be children is dominant. This does not mean that children do not learn a great deal. Ability to work in groups is high on the agenda. (The centers also provide nooks in which youngsters can sit by themselves and daydream.) The children also help with all the housekeeping activities-preparing meals, setting the tables, putting toys away, and cleaning up at the end of the week. In addition, there are field trips and visits to parents’ workplaces and even to each others’ homes when this can be arranged. Every center has a book corner, and children are encouraged to take out books and look at the pictures or listen as a teacher reads stories to them. As would be expected, this means that many children actually do learn to read. “That we are not allowed to teach reading and writing,” said one teacher, “does not mean that I won’t help them when they come to me with questions.”
In the last year of kindergarten, some time is set aside each week for “preparation for school,” which consists largely of learning to sit still and listen to a teacher. Throughout preschool, there are many opportunities to learn, including planting flowers and vegetables in the playgrounds and measuring the ingredients in preparing meals. On a visit to Ballerup, a small working-class city not far from Copenhagen, we went unannounced into a room where four-year-olds were making chocolate truffles. One youngster turned to us, asked our names, and then, without adult coaxing, walked over to offer us some of the chocolate treasures. Unaffected self-assurance seemed to us the mark of children everywhere.
Ballerup also boasts twelve so-called Discovery Playgrounds-extensive plots of land where children raise vegetables and keep and tend a large variety of animals. The mayor, who took us around one of the playgrounds, proudly pointed to a chicken coop. “The children first learn about chickens laying eggs and then they learn how to make scrambled eggs out of them,” he said. The same playground also had five ponies, and we watched a group of teenagers groom them. Part of the Danish child-care/kindergarten system is the addition of so-called clubs to which school-age young people (up to age eighteen or even twenty) may come after school and into the evening for sports, arts, pool, motorcycle repair, and so forth. Moreover, the teenagers are encouraged to help with the little children.
Parental participation is invited at all levels. Most centers post large bulletin boards with the photographs of all the staff members, including the kitchen and cleaning help. Every day, the boards provide information about who among the staff has been present and which groups of children they dealt with. Another board lists the activities in which each child took part, the lunch menu, and so forth. Since there are no written reports, parents meet periodically with teachers and directors to remain informed about their children.
Consultants inspect the centers. Their main criterion in judging programs, we were told, is “how happy the children seem to be.” Copenhagen has approximately six hundred centers/kindergartens/clubs.
Since there are still insufficient places to serve all children (in Copenhagen about 65 percent of the eligible children gain admission, and there is a waiting list), Scandinavia has organized an effective system of child-care mothers who may take in about four children in addition to their own one or two. These child-care and kindergarten mothers are carefully screened and inspected, and they are paid, though not as much as the child-care professionals.
Their job is indeed a tough one. They must take in the children early in the morning and keep them until the parents return from work. While they may do some of the housework together with the children, they are not allowed to go out to do their shopping. They are, however, encouraged to take advantage of special regional centers, perhaps once a week, partly to make their task easier and partly to help the children adjust to membership in a larger group. Also helpful is the availability of “toy libraries” where child-care mothers can check out games and other play materials. Being a child-care mother is not an easy job, but the mothers we met seemed pleased with their assignment. Asked what happens when some of the children move on either to centers or to school, one young mother said: “Everybody cries a little.”
Child care of the quality offered in Scandinavia is expensive. Sweden estimates the cost at about $20 billion annually, and if the announced goal of a place for every child by 1991 is to be reached (it is estimated that about 65 percent would actually avail themselves of it), this would add another $4 billion. The state and the local community each pay forty-live percent of the cost with parents paying the additional 10 percent. Denmark, which operates on a more modest scale, asks parents to pay up to 35 percent of the bill, with the rest split between the national government and the local community. For the first three years, this costs parents about $230 a month; kindergarten comes to about $150 a month. However, no child is excluded because of parents’ inability to pay. When insufficient places are available, top priority goes to immigrant, handicapped, and poor children, in that order.
If a center has four or more children who speak only a foreign language, a native speaker must be provided several hours each week to teach the children in their own tongue. In addition, they are given extra instruction in the relevant Scandinavian language. In many instances, we found, such services are provided even if there is only one child in need of it. Clearly, such individual attention and commitment to bilingual education raise the cost of the centers.
All of these services require considerable expenditures. In Sweden, the estimate is that child care and kindergarten amount to about $10,000 a year per child. (Arrangements in Denmark and Norway are less lavish; the estimated cost is between $5,000 and $7,500 in Denmark and considerably less in Norway, a relatively poor country.) The cost in Sweden could probably be reduced substantially without sacrificing quality, but it is difficult to cut back on personnel without stepping on the toes of vested interests, such as the child-care professionals. Our hints that a modest increase in the number of children admitted to a center without added space or new construction were not well received. In fact, however, it will be difficult to reach the 1991 target of a place for every child, not only because of the added cost but for lack of sufficient manpower. Sweden has less than 1 percent unemployment. In Denmark, with an unemployment rate of almost 8 percent, expansion would be easier.
COST AND DIVERSITY
Some Swedish child-care experts are actually beginning to advocate a somewhat less costly approach. For example, Birgitta Stroembom, an art historian and child psychologist in Upsala, is introducing a new kindergarten called “Little Ones Learn.” She plans to operate with one teacher for twelve four-, five-, and six-year olds, and one teacher and an assistant for eighteen three-year-olds. Altogether, she will run the center with one-third the staff that is currently considered the norm. She will bring in catered food and cleaning services. All children would have to stay through the educational part of the day, roughly until noon. Her ideas of early learning clearly are in conflict with existing policies. This revolutionary approach has already run into some opposition, but Stroembom persists. “It is difficult to understand that in a democratic society it is dangerous to express a different opinion,” she told a hostile assembly of educators recently, after having been verbally attacked. “They actually started to apologize,” she said.
She says she understands why elementary school teachers do not want some children to arrive with reading and writing skills. If they did, established teaching methods would have to be changed. The point, she says, is to find a middle way between pushing the children and putting a lid on their development. She advocates a program that stresses listening to and telling stories (not too different from the established order) but also teaching that three ants are more than two elephants. Birgit Groth, a Montessori method teacher, agrees. “The job is to give children the opportunity to learn.”
While the majority of Sweden’s centers are operated by local communities, only about half of the Danish centers function under such official auspices. The other half are nongovernmental, sponsored by churches, the Red Cross, and other private organizations. Even the officially run centers differ considerably from town to town, depending on the preferences and relative affluence of local communities. Moreover, attendance is never compulsory, though the fact that an ever increasing number of mothers are in the work force (in Denmark, it is 90 percent, the highest in the Western world) leaves relatively little choice for many families.
The high cost of child care is an obvious problem, especially in Sweden where there is a strong movement to reduce taxation from its present top level of 70 percent to something closer to 50 percent for the highest income brackets. Equally serious is the already mentioned shortage of trained staff. Another nagging problem is the transition from kindergarten to elementary school. After six years of virtually total care, available roughly from 7:00 A.M. to 7:00 P.M. (with some local modifications), children transfer to elementary schools that are in session for only three to four hours a day. This is difficult for working parents and invites something like the American latchkey children. This problem is made more manageable in Denmark through the availability of after-school facilities, the “clubs” mentioned above where school-age and adolescent youngsters can spend their free time in a variety of activities under appropriate supervision.
The ongoing controversy over the extent to which children should be permitted to learn such things as basic skills in the preschool programs needs resolution. The present prohibition against any formal teaching may have to be modified, but it is to be hoped that this can be done without going to the Japanese and even the American extreme of pushing children prematurely out of the joys of early childhood.
Related to this controversy is the current debate as to whether the school-starting age should be lowered from seven years to six. Finance authorities favor this for fiscal rather than educational reasons: Schools, with their limited hours and less lavish staffing, are much cheaper. The Education Ministries would prefer to keep the present arrangement because they consider them pedagogically sound.
How much of the Scandinavian experience could be adapted to American use? Clearly, costs would have to be brought into closer relationship with American taxation. Jumping instantly from the Scandinavian model to American practice is impossible. The greater diversity of the American population presents some obstacles, even though Scandinavia has, in recent years, managed to respond to its own greater population mix. In particular, its approach to bilingual education could be a model for the United States. The most important lesson for the United States, pointed out above, is the existence of a child policy in Scandinavia that is fully accepted by liberals and conservatives alike. Such a policy is sadly lacking here. Unless it evolves rapidly, the lot of children, and the damaging impact on the nation, will become worse, with serious consequences for our public life. This issue is intimately related to the need for a rational response to changed family and work patterns.
The Scandinavian realization of the crucial importance of parental leaves immediately before and for a sufficiently long period after childbirth should be carefully studied in the United States. Prenatal care is essential to any hope of reducing infant mortality and of avoiding long-term, and even permanent, damage to children.
Although not discussed here, the introduction in Norway of an ombudsman (Commissioner for Children) and the availability of special telephone numbers published in every telephone directory for use by children should be given some attention. It is obviously impossible to introduce such a system nationwide; but local or, in the case of cities, district-wide hotlines through which children could voice their complaints or fears on a confidential basis seems a sensible way of preventing many situations that are abusive or damaging to children.
Finally, Scandinavian comparisons made clear to us that even the best programs currently available for young children in the United States fall seriously short of what is needed. They are deficient in the numbers of hours during which they serve children and they lack adequately trained and paid personnel. Even Head Start, one of the best programs devised in the service of disadvantaged children, suffers from being too little and too late.
Scandinavian policy is based on the documented fact that what happens to children in the early years, and indeed before birth, is crucial to their future development- their success in school and in work and their contribution to society. Scandinavia is aided in shaping a successful policy on childhood by the narrower gap between the poor and the rich. While there are wealthy Scandinavians and poor families, there are none of the obscenely rich (who in the United States often contribute little to the prevention of poverty) and there are none who live in abject poverty or homelessness. The risk to the United States in failing to reach a national consensus on a policy for children is the continued flow of severely disadvantaged children through the pipeline that feeds them into a permanent underclass. This is a threat to the nation’s future.
It is precisely because the American people, and increasing numbers of policymakers, are finally looking at the needs of children, for the good of the children and of society, that it appears to us frivolous and even callous not to take a hard look at Scandinavia- the best available example of what might be done.